Recent advances in diagnostic testing and therapeutic management have improved our ability to deliver effective care to patients with hemostatic and thrombotic disorders. Many patients still receive inadequate care, however, related to incomplete or incorrect diagnostic testing, inadequate management strategies, or lack of access to facilities with multi-disciplinary expertise. The Duke Thrombosis and Hemostasis Center, one of the founding centers in the Thrombophilia Pilot Program supported by the Centers for Disease Control and Prevention (CDC), integrates areas of clinical expertise to provide coordinated care for patients with thrombotic and hemorrhagic disorders. The Center maintains a patient registry, provides access to clinical research protocols, emphasizes patient education, and has developed a training program for providers interested in disorders of hemostasis. The primary objective of this proposal is to enhance development of the Duke program as a participating institution with the CDC and other Centers in the Thrombosis and Hemostasis Research and Prevention Network. We propose to accomplish this through the following Aims: (1) Establish the Duke Thrombosis and Hemostasis Center as an integral member of the CDC-sponsored Research and Prevention Network to collaboratively develop research, educational objectives, and establish diagnostic and therapeutic standards for patients with complex hemorrhagic and thromboembolic disorders;(2) Enhance patient care by developing evaluation tools that measure clinical outcomes, quality of life and patient satisfaction, improving patient understanding of thromboembolic and hemorrhagic disorders, and expanding the delivery of care to underserved populations across the Network;(3) Develop and implement a research agenda through the Network to address unanswered epidemiologic, diagnostic, and therapeutic questions;and (4) Promote training programs that foster the development of independent researchers and expert clinicians and other providers in thrombosis and hemostasis.We propose to work with the Centers for Disease Control and Prevention to continue our participation in the development of a network of Thrombosis and Hemostasis Centers. These Centers will provide multidisciplinary expertise for patients with complex clotting and bleeding problems, improving the care that we can deliver to these patients. In addition, the Centers will provide access to the most up-to-date clinical research, as well as educational opportunities for patients and providers.